All About Health

If the health insurance exchanges and the individual mandate survive the Supreme Court, maybe health insurance would start looking like auto insurance.

I have insurance broker friends who say that would never happen — too many choices would be too confusing and how would you find the panel of doctors, hospitals and other providers to take the gazillion and one choices of plans?

Well, I doubt there’d be a gazillion and one. I think plans would resemble each other because we have a population and struggles with health literacy and too many choices would be overwhelming.

But if we have exchanges where we can shop for insurance as we do car insurance, the recent controversy over contraceptives would not have happened. Exchange plans would require certain things — a minimum for hospitalization or other catastrophes, no out-of-pocket costs for preventive care — but I think much of the plans would be a la carte. If you are opposed to contraceptives (or don’t need them), you wouldn’t have to purchase that coverage. Same with alternative medicine. If you don’t go to the chiropractor or acupuncturist, don’t buy coverage. Don’t use many prescription medications? Take the minimum coverage for that. You also can pick your deductible based on what you can afford, and your premium would reflect that.

Here’s the big advantage that exchange plans could provide: People would start to take better care of themselves. If you have a lot of auto accidents, your premium goes up. If you use the doctor a lot, you’ll pay more. Exchange policies should have a stop-loss, meaning if you exceed a certain amount in out-of-pocket expenses, the insurer picks up the rest. Having more people buying insurance would spread the risk and make that palatable. It’s similar to a high-deductible plan now. But if you’ve gone five years and not exceeded the cap, you should get a reduction in your premium for the next year.

This also would make the mandate easier to bear for those saying the government can’t tell them what to do. Buy the minimum policy — hospitalization only — and take your chances that you’ll never sprain an ankle, break a leg or need an outpatient surgery or that you have several thousands in the bank to cover that event.

I’m hoping that the people who are putting together the exchanges are really smart and have thought of how to make health insurance better and are not just giving us a different way to buythe same thing. Here’s an opportunity to improve a system. Let’s not miss it.

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About this blog

Patti Singer

Health Reporter

Being healthy means that you’ll be in good shape if you get sick. That may sound odd, but think about it. We may not be able to prevent every illness, but if we can delay it, minimize it and recover quickly, we can get back to our lives. That’s the beauty of a healthy lifestyle – what I call wellness insurance.

I’m fascinated by how we define health and what we do to achieve and keep that physical, emotional and spiritual sense.

I used to be a sports writer. I joined the Democrat and Chronicle in 1985 to write about the Rochester Red Wings and wouldn’t trade that experience for an infinite number of first-round draft choices. I moved from sports to features in 1991, and wrote about personal health, travel and general topics. I joined the metro staff in July 2009 to focus on health.

I am certified as a personal trainer and I earned a master’s degree in education from The College at Brockport, where I teach an undergrad course in contemporary health issues and a grad course in health communication.